LEFT: 46 year-old woman with a polyp seen at routine screening sigmoidoscopy. Although benign in appearance, the polyp contained adenocarcinoma invading the muscularis mucosae. There was no invasion of the stalk, and polypectomy was therefore curative.
CENTER: 53 year-old woman with rectal bleeding and a family history of colonic carcinoma, with this small (1 cm) benign-appearing polyp which contained adenocarcinoma invading the stalk.
RIGHT: 47 year-old man with severe microcytic anemia and fecal occult blood positivity. This pedunculated tubular adenoma contained adenocarcinoma which did not invade the stalk. Like the two polyps shown at LEFT and CENTER, this polyp had a grossly benign appearance.
LEFT: 59 year-old man with rectal bleeding. Large smooth polyp on a broad stalk, containing invasive adenocarcinoma.
CENTER: Sessile polyp in the sigmoid colon of a 77 year-old woman with anemia. Although the polyp was moveable and therefore not fixed to the underling colonic wall, it histologically contained submucosal adenocarcinoma.
RIGHT: Same sessile polyp shown in CENTER photo, having been injected submucosally with saline, to elevate it away from the remainder of the colonic wall prior to excision with a snare using electrocautery.
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